The move is expected to face litigation from the drugmakers and criticism from Republican lawmakers.
Bottles of medicine ride on a belt at the Express Scripts mail-in pharmacy warehouse in Florence, N.J.
The move is expected to cut costs for some patients but faces litigation from the drugmakers and heavy criticism from Republican lawmakers. It’s also a centerpiece of the Democratic president’s reelection pitch as he seeks a second term in office by touting his work to lower costs for Americans at a time when the country has struggled with inflation.
Biden plans to deliver a speech on health care costs from the White House later Tuesday. He’ll be joined by Vice President Kamala Harris. More than 52 million people who either are 65 or older or have certain severe disabilities or illnesses get prescription drug coverage through Medicare’s Part D program, according to CMS.
Currently, pharmacy benefit managers that run Medicare prescription plans negotiate rebates off a drug’s price. Those rebates sometimes help reduce premiums customers pay for coverage. But they may not change what a patient spends at the pharmacy counter. PhRMA representatives also have said pharmacy benefit managers can still restrict access to drugs with negotiated prices by moving the drugs to a tier of their formulary — a list of covered drugs — that would require higher out-of-pocket payments. Pharmacy benefit managers also could require patients to try other drugs first or seek approval before a prescription can be covered.
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